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Individuals with a family history of cancer may be at increased risk of pancreatic cancer. Ashkenazi Jewish (AJ) individuals carry increased risk for pancreatic cancer and other cancer types.
We examined the association between family history of cancer, AJ heritage, and incident pancreatic cancer in 49 410 male participants of the prospective Health Professionals Follow-up Study. Hazard ratios (HRs) were estimated using multivariable-adjusted Cox proportional hazards models.
During 1.1 million person-years (1986-2016), 452 participants developed pancreatic cancer. Increased risk of pancreatic cancer was observed in individuals with a family history of pancreatic (HR, 2.79; 95% confidence interval [CI], 1.28-6.07) or breast cancer (HR, 1.40; 95% CI, 1.01-1.94). There was a trend towards higher risk of pancreatic cancer in relation to a family history of colorectal cancer (HR, 1.21; 95% CI, 0.95-1.55) or AJ heritage (HR, 1.29; 95% CI, 0.94-1.77). The risk was highly elevated among AJ men with a family history of breast or colorectal cancer (HR, 2.61 [95% CI, 1.41-4.82] and 1.92 [95% CI, 1.05-3.49], respectively).
Family history of pancreatic cancer was associated with increased risk of this malignancy. Family history of breast or colorectal cancer was associated with the increased risk among AJ men.
Subject terms: Risk factors, Cancer epidemiology, Pancreatic cancer
Family history of cancer, Ashkenazi Jewish ancestry, and pancreatic cancer risk
Tsuyoshi Hamada,#1 Chen Yuan,#2,3 Matthew B. Yurgelun,2 Kimberly Perez,2 Natalia Khalaf,4 Vicente Morales-Oyarvide,2 Ana Babic,2 Jonathan A. Nowak,5 Douglas A. Rubinson,2 Marios Giannakis,2,6,7 Kimmie Ng,2 Peter Kraft,3,8 Meir J. Stampfer,3,9,10 Edward L. Giovannucci,3,9,10 Charles S. Fuchs,11,12,13 Shuji Ogino,#1,3,5,6 and Brian M. Wolpincorresponding author#2
2019 Apr 16;
Pneumonia is the most common cause of death in patients with dementia, but the outcomes of patients with dementia hospitalized with pneumonia are poorly understood. We sought to illuminate the association between dementia and in-hospital mortality and discharge status in patients hospitalized with pneumonia.
We used the Diagnosis Procedure Combination database, a national inpatient database in Japan, to identify retrospectively patients aged ≥60 years admitted to hospital with pneumonia during the study period of May 1, 2010 to March 31, 2014. We recorded their sex, age, body mass index, severity of pneumonia and comorbidities (including dementia). The outcomes were in-hospital mortality and discharge home. Multivariable Cox regression analysis was performed to analyze factors influencing discharge home.
We identified 470,829 patients hospitalized with pneumonia; 45,031 were recorded as having dementia (9.6%). In-hospital mortality was 13.1% and 13.4% in patients with and without dementia, respectively (P = 0.63). The proportions of patients discharged home were 52.9% and 71.3% in patients with and without dementia, respectively (P < 0.001). The adjusted hazard ratio for discharge home for patients with dementia was 0.68 (95% confidence interval, 0.67-0.69; P < 0.001). Conclusions In-hospital mortality from pneumonia did not differ significantly between patients with and without dementia; however, those with dementia were less likely to be discharged home.
Cognition, Cohort studies, Hospital mortality, Patient discharge, Respiratory tract infection
Association between dementia and discharge status in patients hospitalized with pneumonia
Taisuke Jo,corresponding author1,2 Hideo Yasunaga,3 Yusuke Sasabuchi,1 Nobuaki Michihata,1 Kojiro Morita,3 Yasuhiro Yamauchi,2 Wakae Hasegawa,2 Hideyuki Takeshima,2 Yukiyo Sakamoto,2 Hiroki Matsui,3 Kiyohide Fushimi,4 and Takahide Nagase2
Background: Observational studies suggest an inverse association between whole-grain (WG) consumption and inflammation. However, evidence from interventional studies is limited, and few studies have included measurements of cell-mediated immunity.
Objective: We assessed the effects of diets rich in WGs compared with refined grains (RGs) on immune and inflammatory responses, gut microbiota, and microbial products in healthy adults while maintaining subject body weights.
Design: After a 2-wk provided-food run-in period of consuming a Western-style diet, 49 men and 32 postmenopausal women [age range: 40-65 y, body mass index (in kg/m2) <35] were assigned to consume 1 of 2 provided-food weight-maintenance diets for 6 wk. Results: Compared with the RG group, the WG group had increased plasma total alkyresorcinols (a measure of WG intake) (P < 0.0001), stool weight (P < 0.0001), stool frequency (P = 0.02), and short-chain fatty acid (SCFA) producer Lachnospira [false-discovery rate (FDR)-corrected P = 0.25] but decreased pro-inflammatory Enterobacteriaceae (FDR-corrected P = 0.25). Changes in stool acetate (P = 0.02) and total SCFAs (P = 0.05) were higher in the WG group than in the RG group. A positive association was shown between Lachnospira and acetate (FDR-corrected P = 0.002) or butyrate (FDR-corrected P = 0.005). We also showed that there was a higher percentage of terminal effector memory T cells (P = 0.03) and LPS-stimulated ex vivo production of tumor necrosis factor-α (P = 0.04) in the WG group than in the RG group, which were positively associated with plasma alkylresorcinol concentrations. Conclusion: The short-term consumption of WGs in a weight-maintenance diet increases stool weight and frequency and has modest positive effects on gut microbiota, SCFAs, effector memory T cells, and the acute innate immune response and no effect on other markers of cell-mediated immunity or systemic and gut inflammation. This trial was registered at clinicaltrials.gov as NCT01902394.
gut microbiota, healthy adults, immune, inflammation, whole grains
Substituting whole grains for refined grains in a 6-wk randomized trial has a modest effect on gut microbiota and immune and inflammatory markers of healthy adults1,2,3
Sally M Vanegas,4,5 Mohsen Meydani,4 Junaidah B Barnett,4 Barry Goldin,5,6 Anne Kane,6 Helen Rasmussen,4 Carrie Brown,4,10 Pajau Vangay,7 Dan Knights,8 Satya Jonnalagadda,9,11 Katie Koecher,9 J Philip Karl,4,12 Michael Thomas,4 Gregory Dolnikowski,4 Lijun Li,4 Edward Saltzman,4,5 Dayong Wu,4,* and Simin Nikbin Meydani4,*